The most commonly performed plastic surgical operation in the United States is liposuction. In the last decade the number of patients undergoing the procedure has increased from 47,212 to 195,135 annually. A number of studies have recently been undertaken in order to examine the safety of liposuction because of highly publicized morbidity and mortality statistics and high profile case reports of deaths due to liposuction. Little is known about the physiology of large volume liposuction. Patients are exposed to prolonged procedures, general anesthesia, fluid shifts and infusion of high doses of epinephrine and lidocaine. At the University of Texas Southwestern Medical Center, in the porcine model for large volume liposuction no cardiovascular changes were observed in 9 animals; however, subclinical fat embolism to the lungs was demonstrated. (see Basic Research projects)

In our work on five human volunteers undergoing larger volume lipoaspiration, the safety of liposuction was examined by measuring multiple physiologic and pharmacologic data. These included 1) lidocaine pharmacokinetics, 2) epinephrine pharmacokinetics, 3) hemodynamic and thermoregulatory physiology and 4) electrolyte liver analyte analysis. Based on our data we have outlined a number of key recommendations in four manuscripts in the Journal of Plastic and Reconstructive Surgery.